A cross sectional survey of secondary prevention measures in patients with peripheral arterial disease in primary care

Background: The National Service Framework for Coronary Heart Disease defines standards for the secondary prevention of cardiovascular disease in at risk individuals, including those with peripheral arterial disease. This cross-sectional survey aimed to assess current standards of secondary prevention and health monitoring in patients with peripheral arterial disease following a vascular procedure, and additionally compare care in patients with and without diagnosed coronary heart disease. Methods: Indicators for this survey were identified from national recommendations and evidence. A retrospective review was conducted of GP records, for patients who were treated in hospital for peripheral arterial disease. Results: Data were collected for 103 patients from 42 practices. Overall, prescribing was well achieved for antiplatelets but poor for statins. Standards of assessment of blood pressure, smoking status, and smoking cessation advice were high. However, approximately only half of patients received advice about exercise or had their body mass index checked. Furthermore, for all indicators, standards of care for patients who additionally had a diagnosis of coronary heart disease, were better than for patients without coronary heart disease. Conclusion: The cross-sectional survey suggested the treatment received by some patients with established peripheral arterial disease is substandard. There is considerable potential to increase secondary prevention of coronary heart disease in patients with peripheral arterial disease in primary care.